Defending yourself against the silent killer

Nick Rose, M.S.

This article was originally published in February 2018

blood pressure pump

Under new blood pressure guidelines, half the U.S. population is now at risk for hypertension. Luckily there are numerous ways to treat and prevent this “silent killer.”

I don’t know about you, but I’m much more of a salty-snack, “chips” kind of a guy now than the sweet-toothed, sugar monster I was as a child. It’s common knowledge that high-sodium diets can lead to high blood pressure, but newer research suggests that added sugars are equally pernicious: so, both us savory snackers and you cookie monsters should get our blood pressures checked regularly.

High blood pressure (hypertension) is called a “silent killer” because it has no obvious symptoms to indicate that something is wrong, despite being a major risk factor for heart disease. Approximately half of all strokes and heart attacks are attributed to hypertension, as well as increased risks of vision loss, kidney disease, dementia and sexual dysfunction.

High blood pressure should now be treated at 130/80 according to new recommendations by the American College of Cardiology and 10 other health organizations (the previous guideline was 140/90). As a result of these new guidelines, doctors are now discussing hypertension with an additional 30 million adults. Hopefully they’re using words such as vegetables, fruit and home-cooking, because diet should always be the first line of treatment for mild and moderate hypertension.

Defend with a DASH diet

Both your doctor and your search engine will tell you that the best diet to treat high blood pressure is the DASH diet (Dietary Approaches to Stop Hypertension), emphasizing fruits, vegetables, whole grains, beans, nuts, low-fat dairy, seafood and poultry. This dietary pattern probably sounds pretty familiar, as this diet also reduces the risk for diabetes, osteoporosis, kidney stones, cancer and heart failure, and is endorsed by the Dietary Guidelines for Americans as an example of a healthy eating pattern for all. The DASH diet was developed by the National Institutes of Health and first presented to the public in 1998. It has remained one of the most popular diets, earning “best overall eating plan” seven years in a row by US News & World Report.

The DASH diet is low in sodium and emphasizes foods rich in potassium, magnesium and calcium — electrolyte minerals that regulate blood pressure. Potassium and sodium work together in our bodies to regulate fluid balance and the ratio of potassium to sodium in the diet is a strong indicator of risk for heart disease. Eating more potassium-rich fruits and vegetables is one of the most effective dietary strategies to improving your blood pressure. Most Americans consume less than half the recommended 4,700 mg/day of potassium, so there is much room for improvement.

If you eat a lot of packaged foods, your sodium intake can become quite high because salt is used as a preservative and flavor enhancer. Most salt in the U.S. diet (75 percent) comes from packaged foods, not the salt shaker. Here is a useful tip when reading food labels: look for foods with a 1:1 ratio of sodium to calories. Most Americans consume approximately 2,000 calories/day, and our sodium recommendation is less than 2,300 mg/day — so looking for packaged foods with an equal ratio of sodium to calories prevents overconsumption of sodium throughout the day.

Some research suggests that limiting added sugar is as important, or potentially more important, than sodium in influencing blood pressure. For example, a single serving of soda can raise blood pressure 15 points and, according to the British Medical Journal, “added sugars probably matter more than dietary sodium for hypertension.” The DASH diet recommends moderate alcohol consumption but warns that excessive drinking can raise blood pressure.

The DASH diet was an early example of the benefits of a whole foods and plant-based diet in supporting healthy blood pressure. Researchers are now exploring additional benefits of adding specific foods into the diet, based on encouraging results with beets, olive oil, and other mighty plant foods. (See sidebar.)

Alternative approaches

In addition to diet, there are a variety of other approaches to help manage blood pressure. Regular exercise can reduce blood pressure up to nine points. Exercise strengthens the heart, so that it pumps blood more efficiently, resulting in less “pressure” on the arteries from each pump. As your body weight increases, so does your blood pressure, therefore weight loss can also lead to a significant reduction in blood pressure (up to 10 points). Even small amounts of weight loss can reduce your blood pressure significantly.

Researchers are currently exploring the potential for acupuncture and mindfulness meditation in treating hypertension. Peer-reviewed, randomized, placebo-controlled trials find that the benefits of acupuncture can be as effective as prescription drugs — lowering both systolic and diastolic blood pressure four to eight points. The benefits are even more pronounced when these therapies are combined with other dietary and lifestyle approaches.

The research on acupuncture and hypertension is growing and there appears to be point-specificity, meaning that the acupuncture needs to include specific acupuncture points. Clinical research conducted at the University of California-Irvine in both humans and animals finds that approximately 70 percent of those with mild to moderate hypertension respond to treatment after about eight weeks. Using an animal model, researchers have shown how acupuncture works: by influencing the autonomic nervous system and areas of the brain responsible for regulating-blood pressure.

World renowned integrative medicine pioneer Dr. Andrew Weil advocates the 4/7/8 breathing technique, practiced twice a day, and reports that after two to three months, this “relaxing breath” can lower heart rate and blood pressure, as well as help to manage stress and anxiety. The 4/7/8 relaxing breath is “utterly simple, takes almost no time, requires no equipment and can be done anywhere” according to Dr. Weil. Pay attention to your breathing and count to four while inhaling, hold your breath for a count of seven, and then exhale through your mouth for a count to eight. Repeat this cycle for a total of four breaths.

Taking charge of your health

A 2017 NPR report described most medical providers as so rushed to get through appointments that they don’t always take blood pressure measurements correctly. Rather than relying on stressed-out and hurried doctors, many people use a home blood pressure monitor. It’s best to check your blood pressure at different times of the day and to keep a log to share with your doctor. To get the most accurate measurements, you should sit still (and relaxed) for at least five minutes prior to each measurement. Sit with your back straight and your feet flat on the floor, legs uncrossed, and avoid eating, caffeine or exercise for at least 30 minutes prior to measuring.

The “silent killer” sounds pretty scary but, luckily, we have many weapons to defend ourselves! I can dip my salty chips into an olive oil-rich hummus and you cookie monsters can brew up a pot of hibiscus tea. We all can make progress on getting more veggies and fruits into our diet because our health is priceless.

Mighty foods to lower blood pressure

  • Flaxseed provides soluble fiber, omega 3 fatty acids and magnesium. Research published in the journal Hypertension found that flaxseeds induced “the largest decrease in blood pressure ever shown by any dietary intervention” with two tablespoons per day for several months.
  • Extra virgin olive oil contains polyphenols that reduce blood pressure, inflammation and other risk factors for heart disease. Researchers have found that when saturated fat in the diet is replaced with olive oil, blood pressure is lowered significantly enough to reduce medication dosage.
  • Beets are a uniquely rich source of dietary nitrates, which contribute to vasodilation — a relaxation of the blood vessels, which supports blood pressure and heart health. Just one glass of beet juice per day can have significant benefits. Dietary nitrates are also found in arugula, celery and Swiss chard.
  • Cocoa contains flavanols (also found in apples, grapes and tea), which help relax and widen the blood vessels, similarly to beets. The flavanols in cocoa have additional benefits for the heart, improving blood cholesterol levels, protecting blood vessels from damage, and enhancing overall blood flow.
  • Hibiscus tea has been found to lower blood pressure significantly when added to the diet of hypertensive older adults. The effects are found to be quite robust when drinking three 8-ounce cups of tea each day for at least six weeks.

I’ll be diving even more into the value of heart-healthy foods in my Heart to Heart Talk and Walk tours this month. Visit to learn more!

  • Friday, February 8 at 7 p.m.,
    Edmonds PCC
  • Wednesday, February 21 at 7 p.m., Greenlake Village PCC
  • Thursday, February 22 at 7 p.m., Issaquah PCC

PCC Nutrition Educator Nick Rose enjoys helping others make conscious food choices for improved personal and planetary health. Read more of Nick’s work on his nutrition blog:

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